As New Elizabethans we have seen many great things accomplished by our species. A moon landing, supersonic travel and the establishment of a healthcare system, free at the point of care are some of the great things achieved. However, it is unlikely that man ( the species) will set foot on the moon again in my lifetime, equally unlikely that a commercial supersonic airliner will be available in the next twenty years. Both these two endeavours are of course extremely expensive, idealogically driven and beneficial to some elements of society, but the world has moved on, commercial air travel is moving towards a triumph of mass transit at lower cost instead of speed and luxury. The new Airbus A320 delivers the model required not Concorde. Of course the shift was helped by factors outside the world of aviation, not least the growth of high speed communication -the availability of teleconferencing means that the urgent face to face can happen without a trip on Concorde.In the case of space travel, the high ambition was a political ideal, designed to secure an unassailable position in world history. Although great science was delivered on the back of the programme the cost and financial restrictions globally mean that the programme is no longer viable.

Apply that same logic to the NHS- the cost, the idealism are all possibly rendered obsolete by changes in society, the only factor missing is a viable alternative model to the current system.

Here's where it goes off the rails. The NHS is a complex system, akin to a living organism. There are certain rules about how such systems work, the current world view is that a bottom up clinically led system will deliver "the right thing" for the population. It is possible that it might work, but such an experiment will, as is the way with experiments, result in some failures before it delivers.

The question is whether the evolution of a politically founded, publicly funded healthcare system is able to be delivered rapidly through evolution or like the shift away from manned space flight and commercial supersonic flight, it may require a hard nosed cessation of one system, so another might flourish. Can we take this giant leap for mankind? Is this one exploration too far for the new Elizabethans? Only time will tell.